The Effectiveness of Pulsed Dye Laser Combined With CO2 Fractional Laser in the Treatment of Port-Wine Stain in Chinese Patients: A Retrospective Study

BACKGROUNDPort-wine stain (PWS) is a common type of congenital capillary malformation, often occurring on the face and causing a significant psychological impact on patients. Until now, pulsed dye laser (PDL) remains the criterion standard for PWS treatment, but some patients show poor effectiveness and treatment-resistance. Fractional laser was previously tried for the treatment in several cases of PWS. However, the effectiveness of its combination with PDL is still unclear.

OBJECTIVEThis study aims to investigate the effectiveness of PDL combined with CO2 fractional laser (CO2 FL) in treating PWS.

METHODSA retrospective analysis was performed based on the PWS patients who received PDL combined with CO2 FL treatment in Xijing Hospital, China from January 2014 to December 2024. Clearance rates were recorded to measure clinical effectiveness.

RESULTSA total of 91 PWS patients were enrolled and analyzed. The age range is from 20 days to 60 years (median age, 11 years), 33 males (36.26%), and 58 females (63.74%). The sites of lesions were predominantly located on the head and face (92.31%), followed by the limbs and trunk (4.40%), and the neck (3.30%). Eighteen patients (19.78%) exhibit nodular hypertrophy type. The results showed that after six sessions of treatments, the average clearance rate was 49.85% ± 22.65%, reaching the plateau. To evaluate the optimal timing of the CO2 FL combination, we categorized the patients into two groups: those who commenced the combination of PDL and CO2 FL within the first five sessions, referred to as the early combination group, and those who began the combination after five sessions, designated as the delayed combination group. After eight treatment sessions, compared with the delayed combination group, patients in the early combination group had a higher clearance rate (62.23% ± 23.04% vs. 52.37% ± 22.23%, p < 0.05).

CONCLUSIONThe combination of PDL and CO2 FL is safe and effective for treating PWS. Early combination therapy is associated with better treatment outcomes.

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